KIDDIECARE: Feds Approve Missouri’s Unique Approach

      The U.S. Department of Health and Human Services yesterday approved Missouri's Children's Health Insurance Program (Kiddiecare) proposal, as well as a Medicaid waiver designed to expand coverage to more low-income adults. The Kansas City Star reports that "as many as 90,000 children -- roughly half those who currently lack insurance," will be eligible for government-subsidized health care coverage. Missouri stands to receive as much as $52 million in federal funds, an amount to be matched by nearly $20 million from the state (Murphy/McGuire, 4/29).

MC-Plus And A Side
     
      Missouri will use its new allocation to expand insurance coverage to children within the state's existing Medicaid managed care program. The program will expand eligibility to children up to the age of 18 in families with incomes up to 300% of the federal poverty level ($49,350 for a family of four). In addition to having its children's plan approved, Missouri won federal approval Tuesday to expand coverage to about 94,000 low-income parents who currently lack insurance (4/29). The additional low-income adults will be enrolled under a 1115 Medicaid waiver submitted to the federal government by the state. The 1115 waiver also allows Missouri to enroll Kiddiecare-eligible children in its main Medicaid program after the state's children's health insurance funds are exhausted (HHS release, 4/28). According to the St. Louis Post-Dispatch, most of the children and adults will "be served through MC-Plus," the state's Medicaid managed care program (Young, 4/29).

A Victory For The Kids!
      News of the program "thrilled advocates" who believe it "is as vital for children as the creation of Medicare was for older adults." Sister Berta Sailer, assistant director of St. Vincent's Family Service Center, said, "It will make a lot of mothers sleep better at night, knowing if their kid gets hurt or sick, they won't be bankrupt (by taking them to the emergency room)." But critics "complained the plan is too generous." A Republican state senator "said the plan will encourage thousands of families who already have insurance to drop it because they could qualify for Medicaid." State Sen. Larry Rohbach (R) said, "Missouri should change its motto from the 'Show Me' state to the 'Social Welfare' state" (Kansas City Star, 4/29). State Rep. Pat Naeger (R) said, "Parents with healthy children might drop their coverage and 'buy a big-screen TV instead, or upgrade their car.'"

Final OK
      Missouri lawmakers are still waiting to give final approval to the Kiddiecare plan. The bill (SB 632), sponsored by state Sen. Ed Quick (D) and state Rep. Scott Lakin (D), was sent "to the full House on a vote of 24-12." Under the legislation, eligible children "would get Medicaid services if the parents paid a $5 copayment for each doctor visit and a monthly premium of $50" for the first child and $5 for each additional child (St. Louis Post-Dispatch, 4/29). State "officials hope to start signing up children in July and begin medical coverage as early as September." Missouri was the first state to submit a CHIP plan for federal approval and is the 12th to get that approval (Kansas City Star, 4/29).